News Contraception

Three Minutes, Three Positions On Birth Control

Robin Marty

Mitt Romney isn't quite sure where he stands on anything right now.

Presidential front runner Mitt Romney has been accused of flip-flopping before, but never quite this fast.  Via Think Progress, watch his three different stances on birth control in three minutes.

Analysis Politics

Fact-Checking a Texas Republican’s Claims on Women’s Health ‘Advances’

Andrea Grimes

Texas state Sen. Jane Nelson took to the editorial page of the Austin American-Statesman this week to tout "advances" in women's health care under Republican leadership. But Nelson fudged the facts on her, and her party's, anti-woman voting record.

In an editorial published Wednesday in the Austin American-Statesman headlined “Women’s healthcare advancing under Republican leadership,” Texas state Sen. Jane Nelson (R-Flower Mound) touts what she sees as her, and her party’s, achievements in expanding family planning and cancer-screening care for Texas women. There is no GOP-led “war on women,” she writes, calling the “so-called” war “a purely political campaign designed to paint Republicans as anti-women.”

But the record shows that Sen. Nelson herself cast the first “no” vote against establishing the state’s Medicaid Women’s Health Program in 2005, and Nelson’s editorial deliberately obfuscates some of her party’s most damaging moves toward dismantling the family planning safety net in Texas.

Nelson has become the Texas GOP’s most prominent spokeswoman. She is the Texas senate’s highest-ranking member and the longest-serving chair of the state senate’s Health and Human Services Committee; she also enjoys a number of other top committee and conference committee appointments. When her name is on a bill—or when her vote is called—Republicans take note.

Here, we’ll parse Nelson’s true and not-so-true claims in a paragraph-by-paragraph analysis.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Nelson begins:

When I was first elected to the Texas Senate, Lt. Gov. Bob Bullock appointed me vice chair of the Health and Human Services Committee.

True: In 1999, Nelson was appointed to a split Health and Human Services Committee, with Nelson chairing “health services,” while Democrat Sen. Judith Zaffirini (D-Laredo) was appointed to lead “human services.”

Back then, health care was considered a “women’s issue.”

True-ish: Health care was certainly considered a “women’s issue” in 1999. But in light of the current legal battles over the Affordable Care Act’s birth control benefit, it’s clear that when “health care” involves care specific to people who may become pregnant, a great many Americans perceive it as a “women’s issue” that should be uniquely separated from “health care” writ large.

I never liked that term because, in my mind, all issues are women’s issues. We care about the same issues as men. But health care is of particular interest to women. Our bodies are different than men’s, and so are our health care needs.

True: Female bodies are indeed different than male bodies.

In this new role, it didn’t take long to recognize that our policies were behind the times when it came to meeting the needs of women. The Women’s Health Program didn’t exist. There was little in the way of education about the unique health care risks for women. Medicaid didn’t cover early treatment for breast and cervical cancer.

Barely true: Certainly the Medicaid Women’s Health Program (MWHP) did not exist in 1999, and women’s health and family planning was not an express focus for state lawmakers. But no concrete action was taken on the matter during Nelson’s first term on the Health and Human Services Committee. The New York Times has reported that in 1999, “family-planning advocates” coordinated an “orchestrated push” for state-funded contraception and well-woman exams, but failed.

Over the years, we changed all that. We expanded treatment options for low-income women battling cancer. We made sure mammograms were safe for women. We invested in prevention of breast and cervical cancer.

False: At least in terms of Nelson’s use of “we,” if she means to include herself and Republican lawmakers, writ large, in that designation. In 2001, Sen. Zaffirini authored a Medicaid reform bill, SB 1156, which in part directed the state to work with the federal government on a family planning program. Sen. Nelson was neither a co-author, sponsor, or co-sponsor of the bill. Three senate Republicans co-authored the bill with seven Democrats, and their house sponsors included three Democrats and one Republican. Most notably, Republican Gov. Rick Perry vetoed the bill.

In 2005, we created the Women’s Health Program, providing screenings, wellness checks and family planning services beyond the traditional Medicaid population.

False: In 2005, Sen. Gregory Luna (D-San Antonio) sponsored SB 747, which created the Medicaid Women’s Health Program (MWHP). Three Republican senators authored the bill, most notably John Carona (R-Dallas), along with Sen. Zaffirini. All of the bill’s senate co-authors were Democrats.

Nelson’s use of “we” in this case is especially misleading: She, as chair of the Senate Health and Human Services Committee, cast the first official “no” vote against the program at a hearing on March 22, 2005. Watch the record vote here:

Nelson only later supported SB 747 after other Republican lawmakers amended the bill to ensure that WHP patients would be barred from receiving emergency contraception and would receive information “emphasizing the health benefits of abstinence from sexual activity,” and after an amendment preventing  “abortion affiliates” from providing MWHP services was attached to the bill. That “abortion affiliate” amendment would ultimately later lead to the ouster of Planned Parenthood from the MWHP in 2012 and the wholesale dismantling of the program. Lawmakers later created the Texas Women’s Health Program (TWHP), a program that, without Planned Parenthood, has seen a 77 percent decline in clients served—at an increased cost per client—compared to the original MWHP. In hindsight, Nelson’s voting record shows that she expressly supported the provisions of the bill that ultimately led to the demise of the program and a drastic decrease in services provided to low-income Texans most in need of affordable family planning care.

Today there are four main programs specifically tailored to women. They are expected to reach more than 400,000 women and have a combined budget of over $240 million.

Truthy: Nelson appears to be speaking of the following: the Texas Women’s Health Program, another state family planning program, the Expanded Primary Health Care Program, and a fund for breast and cervical cancer screenings, as laid out on page 11 of this February 2014 Department of State Health Services presentation. Those four programs do indeed have a combined budget of $240.1 million. At first glance, this appears to be a massive increase from the previous fiscal biennium’s $127.3 million budget. But what Nelson fails to mention is that she personally signed her name to a 2011 budget that slashed family planning funds by $67 million—meaning that any actual funding increase is more to the tune of $40 million, and of services paid for by the $100 million increase, only two-thirds of the primary care program must be family planning services. If Nelson claims that the funding increases are remarkable, it is true only because the previous budget cuts she herself endorsed were so substantial.

Women’s health has advanced under Republican leadership.

False: Over the last 15 years—under a decade and a half of statewide Republican leadership and strong GOP majorities in both the Texas house and senate—maternal mortality in the state has quadrupled. According to the Texas Policy Evaluation Project at the University of Texas, 59 reproductive health-care clinics—none of which provided abortion care and most of which were located in rural and underserved areas of the state—closed as a result of the 2011 budget cuts; only a handful have reopened as of 2014. Those that remain open or which have reopened must navigate a retooled contraceptive discount system that significantly negatively affects their ability to prescribe the most effective and long-acting forms of contraception.

From 2007 to 2012, the operative years of the Medicaid Women’s Health Program (MWHP) during which Planned Parenthood provided services to about half of the program’s clients, enrollment climbed and the state enjoyed a nine-to-one federal match in funds. The state lost that federal match when Republican lawmakers ousted Planned Parenthood from the MWHP—the provider’s exclusion violates federal law that allows patients to seek care wherever they choose—and enrollment plummeted by the tens of thousands. According to the Department of State Health Services, Texas’ state-funded family planning providers are currently seeing 77 percent fewer clients, at an increased cost of 17 percent per client, than they were before the 2011 budget cuts that Nelson signed off on. In 2013, the Department of State Health Services lost its long-standing claim to a federal Title X grant to an independent organization of Texas reproductive health-care providers who have taken on the work of attempting to repair some of the damage done by the 2011 budget cuts.

And safe, legal abortion in Texas is harder to access than ever today, in part thanks to Jane Nelson, who in 2011 co-sponsored the state’s mandatory ultrasound bill, which forces people seeking abortions to submit to a sonogram at least 24 hours before the procedure, and requires them to listen to their provider’s verbal description of the sonogram. In 2013, Nelson co-sponsored SB 1, the senate’s version of the omnibus anti-abortion bill that has reduced Texas to just 24 legal abortion providers, down from 44 in 2011. In September 2014, when the entirety of the bill goes into full effect, Texas will have just six legal abortion providers.

Sadly, our progress is being undermined by those trying to manufacture a so-called “War on Women” — a purely political campaign designed to paint Republicans as anti-women.

False: While in its literal sense, the use of the term “war” may be considered hyperbolic, in light of the demonstrable crisis in access to affordable reproductive health care in Texas, evidence clearly shows that when family planning and women’s health programs suffer in Texas, they do so at the hands of conservative lawmakers who, leaning ever more to the political right, have privileged political rhetoric against abortion (and “abortion affiliates”) over fiscally conservative, cost-saving family planning policies that serve low-income Texans and lessen the taxpayer burden statewide, in addition to reducing the need for abortion in the first place.

They claim funding, which was reduced during the recession, has not been restored. That is not correct. Not only did we restore funds, we increased them to an all-time high.

True and false: In saying family planning funding “was reduced,” Nelson again fails to mention that she signed off on the budget cuts. And while some specific family planning has been restored since the 2011 cuts, again, the new $100 million increase in funds that prompts Nelson to tout the “all-time high” is directed to the Expanded Primary Health Care Program (EPHC), which may or may not meet its family planning goals in its infancy. In fact, explicitly directed family planning funds are at a four-year low, down to $140.1 million from $201.4 million in fiscal year 2010-11.

They claim the funds approved last session will not enhance family planning. Untrue. We required that approximately two-thirds of the women served through these new resources will receive contraception and other family planning services.

Unknown: Certainly critics of the EPHC have expressed concerns that providers will be unable to make up the difference in clients lost due to family planning cuts; with the EPHC’s recent launch, it is simply too early to tell whether that will truly be the case.

They claim that excluding abortion providers and their affiliates continues to diminish our provider network. Not so. Over 3,000 providers are signed up for the Women’s Health Program — more than double the number participating in 2011.

True, but only through a very short lens: No abortion providers were ever involved in the provision of publicly funded family planning care in Texas; for them to do so would have been a violation of the nearly 40-year-old Hyde Amendment, which bars federal funds from going to abortion care. In 2012, Texas lawmakers deemed Planned Parenthood locations that do not provide abortion, and which keep their funding and operational structure wholly separate from their abortion-providing entities, to be abortion “affiliates,” which did indeed result in an initially drastically diminished provider care network, as Planned Parenthood provided services to about half of the MWHP’s 130,000 or so clients. Since the creation of the state’s replacement program, the Texas Women’s Health Program, the overall provider numbers may indeed have increased, but their individual capacity to efficiently handle the volume of clients at the same low cost as Planned Parenthood, has been questioned.

These claims are irresponsible, politically motivated and hinder our ability to enroll women in these programs. No one should be discouraged from receiving the health care they need because of this misinformation. The services are there. The funding is there.

False: It was Republican-fueled funding cuts and the party’s crusade against Planned Parenthood that hindered the state’s ability to enroll women in family planning programs. In October 2013, a spokesperson for the Texas Health and Human Services Commission admitted as much to the Houston Chronicle, saying that “Planned Parenthood not only served many of the clients, they also helped their patients enroll in the Women’s Health Program.” With regards to misinformation, the Department of State Health Services itself spread a great deal of it in the run-up to the dismantling of the MWHP by advising enrollees to call colonoscopy centers for pap smears. Today, it may be true that between the partially restored family planning funding and the primary health-care expansion that services and funding are available; whether Texans can avail themselves of services offered, again, remains to be seen. If Texans do not or cannot receive services, it will be because Republican lawmakers—and some anti-choice Democrats—intentionally fractured a cost-effective safety net that saved taxpayer dollars and helped Texans plan their families.

We recognize there is more work to do. At our recent hearings, we identified four areas of focus to enhance women’s health: improve education, make it easier to navigate the system, expand our reach in underserved areas and strengthen family planning.

True: The senate Health and Human Services Committee met in February 2014 to discuss what Nelson described as “legislative achievements in women’s health care.”

We will work across the aisle on areas of common ground — without abandoning our principles. We budget within our means. We don’t agree that embracing Obamacare is the right way to expand women’s health care. We oppose using public funds to pay for abortions. These positions are often twisted to mean things they don’t, but the truth is these views are held by most Texans.

True, inasmuch as an opposition to the Affordable Care Act and a stated goal of general fiscal conservatism are an accurate representations of Republican party positions. But it bears repeating that the Hyde Amendment, passed in 1976, already expressly bans public federal funding for abortion, except in extremely limited cases involving rape or incest or the health of the pregnant person. According to the Center for Medicaid Services, only 150 abortions nationwide were funded by Medicaid in 2012. And with regard to Texans’ views on abortion legislation, a 2013 poll conducted by the University of Texas and the Texas Tribune found that only 38 percent of Texans would like to see the kind of stricter abortion restrictions favored by Nelson and her cohorts in the GOP. And while Republicans do oppose the ACA, the attendant Medicaid expansion offered by the federal government, which has been outright refused by Gov. Rick Perry and his GOP allies, would allow an estimated one million Texans—in a state with the highest rate of uninsured adults in the country—to access affordable health care, including family planning services.

Since I became the 10th woman ever elected to the Texas Senate, women’s health has come a long way, and there are more women making decisions about our health care policies than ever before. Seven women now serve in the Senate. Three of us served on the four-person panel that wrote the Senate’s health and human services budget last session.

True: Texas women now hold seven of 31 senate seats. Four of them are Democrats.

That budget, championed by Republicans, included a historic commitment to women’s health. Not only does my party care deeply about the rights, respect and needs of Texas women, Republicans have delivered results for women since becoming the majority party.

False: Republican lawmakers only came around to the idea of increasing family planning funds when they were assured that funds would be funneled through non-specialty primary care providers, and it’s important to remember that the “historic commitment” came after a historic decimation of the family planning safety net in 2011. In the wider view, it would be difficult to say that any part of Texas’ 2013 budget was roundly “championed” by Republicans, despite the fact that they ruled the legislature with a sound majority. Even the right-leaning Texas Public Policy Foundation at one point described the “great Texas budget debate of 2013” thusly: “four conservative senators joined 30 conservative House members in voting against the budget; never had so many members of the majority party voted against the budget.”

Nelson closes her editorial with this:

Women can’t be defined by a narrow list of political wedge issues. We can be anything we want, including proud Red State women who are fighting for women’s health.

Taken as a whole, Texas lawmakers’ efforts in dismantling the state’s family planning safety net make it clear that if any group can be said to be driving “political wedges” into legislation that affects women, it is the Republican party, which has used its opposition to legal abortion—and its party members’ enthusiasm for relegating Roe v. Wade to a historical footnote—to play ping-pong with the most marginalized, lowest-income Texans’ ability to access affordable reproductive health care.

The only Texas women who can be “anything [they] want” are the Texas women who, like Jane Nelson, have the money, means, and privilege to do so. And that group remains as exclusive as ever, especially in light of the fact that Texas Republicans continue to oppose the adoption of a state version of the Lilly Ledbetter Fair Pay Act that was proposed by state Sen. Wendy Davis in 2013—a bill that Sen. Jane Nelson also voted against.

Commentary Politics

Budget Committee Hearing on Poverty Turns Into Nun-Bashing Tournament

Adele M. Stan

House budget committee chairman Paul Ryan presided over a hearing called to assess the "war on poverty." But with a liberal nun on the witness panel, it became a war on religion.

As the budget strategy of House Republicans began to unravel Wednesday with the withdrawal from the floor of a major spending bill, Paul Ryan (R-WI), chairman of the Committee on the Budget, appeared unfazed. He had a plan: Blame the poor and the liberals who seek to keep them from going hungry.

His committee colleagues, however, amended the strategy a bit to this: Blame the nun and her bad theology.

A Wednesday budget committee hearing billed as a “progress report” on the “war on poverty,” clearly convened by Ryan as an indictment of the social safety net, quickly devolved into an inquisition of witness Sister Simone Campbell, the executive director of the social justice group NETWORK who is famous for leading last year’s Nuns on the Bus campaign.

It wasn’t the first time Ryan and Campbell had faced off. Nuns on the Bus first won media attention when Campbell and her fellow sisters launched their road trip during the presidential campaign to protest Ryan’s safety-net-slashing 2012 budget. And, speaking from the podium of the 2012 Democratic National Convention, Campbell said that the budget crafted by Ryan, who is Roman Catholic, flew in the face of Catholic moral teaching.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

So, while Ryan managed to be unfailingly polite to Campbell at the hearing (well, except for failing to laud her as an expert in her field—she’s a family law attorney—or acknowledge her role as the leader of an organization), his colleagues stood ready to take aim at her theology, which they sought to portray as flawed. (The other witnesses were Eloise Anderson, secretary of the Wisconsin Department of Children and Families; Jon Baron, president of the Coalition for Evidence-Based Policy; and Douglas Besharov, professor at the University of Maryland School of Public Policy.)

Ryan’s intent was clear in his opening statement. After saying that the U.S. government had spent $15 trillion in anti-poverty programs since 1964 and had little to show for it, he went on to assert of his hearing, “This isn’t about cutting spending. It’s about improving people’s lives.”

The committee’s ranking member, Chris Van Hollen (D-MD), noted in his opening statement that Ryan’s budget plan calls for converting the Supplemental Nutrition Assistance Program (SNAP), popularly known as food stamps, into a block grant funded at levels one-third below Congressional Budget Office estimates of anticipated need. (Just last month, the House passed a farm bill that eliminated SNAP from the final version, leaving the Appropriations Committee to find another way to fund the program.)

Campbell’s testimony focused on the “faithful budget” on which NETWORK and other faith groups collaborated—a budget proposal designed to address poverty and other social justice needs.

As the question-and-answer session got underway, it became clear that Campbell’s unusual combination of credentials, combined with her liberal politics, got under the skin of members of what is often described as God’s Own Party. Many of the the Republicans who questioned her felt the need to assert their own religious bona fides before lobbing their rhetorical grenades.

Todd Rokita (R-IN) spoke of his Catholic schooling, while Marsha Blackburn (R-TN) began her questioning by saying, “I was teaching a Sunday school class …” And Reid Ribble (R-WI) began his questioning by mentioning all the many pastors in his family. “Christianity is all about the church reaching out to the poor,” Ribble said. “What is the church doing wrong that it needs to come to government (to fund anti-poverty efforts)?” he asked of Campbell.

“I think it’s more a reflection of the dimension of the issue,” Campbell replied. She cited a study issued last year that estimated every house of worship in the nation would have to contribute an additional $50,000 per year for the next ten years in order to make up for Republican budget cuts to the social safety nets of just two states.

Jim McDermott (D-WA) was just beside himself after that. “This hearing is surreal,” he said. “It ought to be about jobs. … We are not living in the real world. Nobody here has to make a decision about whether you feed your kids or not.”

Indeed, a recent Associated Press survey found that “[f]our out of 5 U.S. adults struggle with joblessness, near-poverty or reliance on welfare for at least parts of their lives.”

Barbara Lee (D-CA) lamented the fact that the committee failed to call as a witness anyone who had ever relied on public assistance to get by, although both she and Gwen Moore (D-WI) spoke to their own experience as having relied on the safety net earlier in their lives.

New Jersey Republican Scott Garrett invoked the book of Genesis to suggest that people who receive public assistance don’t want to work, saying, “God actually took man and put him into the Garden of Eden and directed him to work the Garden of Eden. And if I remember my scripture well, it was actually before the fall (from grace). … After the fall, of course, he and Eve had sinned, and it wasn’t so easy to work the Garden anymore; he had the (expulsion) and the rest to deal with. But from a Catholic and Christian imperative, work is a moral imperative.”

And we all know who caused Adam to commit that original sin.

Later in the hearing, Campbell responded to a question from Roger Williams (R-TX), who challenged the wisdom of the Affordable Care Act’s requirements for businesses by saying, “Regulation helps us avoid the wages of original sin.”

Blackburn notched up the religion attack on Campbell by challenging the nun’s Catholic credentials because her group had been targeted by the Vatican’s Congregation for the Doctrine of the Faith during last year’s crackdown by the Holy See on liberal U.S. nuns. It was a shockingly untoward wade by a Protestant into the internal politics of the Roman Catholic Church.

After noting her role as a religion teacher, and asking budget and taxation questions of the witnesses, Blackburn launched her barrage against Campbell. “You say that you come before this committee today … as a Catholic sister rooted in the Christian tradition,” said Blackburn. “Would it be fair for this committee to question the validity of your testimony knowing that the Vatican has reprimanded the Leadership Conference of Women Religious and singled out your organization in an official … doctrine of assessment for only promoting issues of social justice and being silent on the right to life from conception to natural death?”

Responding, Campbell said, “I believe that the [action of the] Congregation for the Doctrine of the Faith is about theological struggles; it is not about our engagement in political activity. And as I said in my testimony, our organization works on economic issues.”

“Is everything in your testimony today compatible with positions taken by the Catholic church?” Blackburn continued.

“Yes,” Campbell replied. She also noted that she is “pro-life.”

Blackburn’s questioning was too much even for Ryan, who stepped in to defend his fellow Catholic from attack by the Protestant lawmaker. After explaining the Catholic teaching on matters of “prudential judgment,” he said, “There are areas where we exercise prudential judgment, and this economic sphere is clearly one where we have exercised prudential judgment and arrived at different conclusions, such as economic growth, poverty, and the rest. I say this as a Catholic who disagrees with you sometimes on these issues, I think you’re well within Catholic teaching to give the testimony that you gave here today.”

But the prize for nun-dissing in Wednesday’s war-on-poverty hearing goes to Todd Rotika (R-IN), who asked Campbell, “What’s the number we have to confiscate in terms of the property of other people in order to solve your budget?”

He didn’t stop there; he kept talking, essentially indicting Campbell as a would-be thief, running out the clock on the time he was allotted before she could answer.

The nun smiled incredulously and threw up her hands when she was prevented from answering. “A cliffhanger,” she joked.

Then Rotika asked for a point of personal privilege, saying that after enduring eight years of Catholic school, he had always wanted to do that to a nun. So proud he was of his performance that he posted the video.

Rep. Todd Rotika’s questioning of Sister Simone Campbell begins at the 4:08 mark.